The fear of flying (FoF) is a common debilitating symptom of specific phobia and agoraphobia that causes substantial impairment in occupational and social functioning, affecting an estimated 10-25 percent of the population. The difficulty and expense of using airplanes for exposure have daunted many researchers and therapists. Virtual reality exposure (VRE) is potentially an efficient and cost-effective treatment of FoF. The feasibility of using this new VRE with patients and preliminary evidence of its efficacy were successfully demonstrated in Phase I. This Phase II proposal aims to compare VRE treatment for the FoF to standard exposure treatment in a larger study with more patients and more complicated patients. Seventy-five patients with FoF will be randomly assigned to one of three groups: VRE, SE, or WL. Standard measures pre- and post-treatment and at a 3 month follow-up and a post-treatment test flight will assess patients' anxiety and avoidance. All assessments will be conducted by a blind Independent Assessor. The long-term objectives include the development of efficacious and affordable turnkey PC systems that will be commerically available to other researchers and therapists to deliver Virtually Better TM virtual reality exposure therapy. PROPOSED COMMERCIAL APPLICATION The commercial applications include 1) the sale of these PC based systems to researchers and therapists to deliver Virtually Better TM virtual reality exposure therapy; 2) the delivery of Virtually Better TM virtual reality exposure therapy in clinics to individual patients; and 3) the training of researchers and therapists in this type of therapy.